Denpa News “Today, there is an increase in the incidence of cancer worldwide. Along with this, the development of radiological diagnostic methods and their widespread use contribute to the diagnosis of oncological diseases at an early stage”.
Today, there is an increase in the incidence of cancer worldwide. Along with this, the development of radiological diagnostic methods and their widespread use contribute to the diagnosis of oncological diseases at an early stage.The survival rate for oncological diseases directly depends on the severity of the cancer.
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In oncology, the following main methods of radiation diagnostics are used:
Ultrasound – (visual technique based on the use of ultrasound waves to obtain an image)
X-ray diagnostics (X-ray method) – the principle of obtaining an image is based on the features of the absorption of X-rays by various tissues of the body
Computed tomography (CT) is an X-ray examination method based on obtaining layer-by-layer images in the transverse plane and their computer reconstruction
Magnetic resonance imaging (MRI) is a method based on obtaining layer-by-layer images of organs and tissues using the phenomenon of magnetic resonance
Radionuclide diagnostics or nuclear medicine is a method of radiation diagnostics based on the registration of radiation from artificial radiopharmaceuticals introduced into the body.
Appropriate additional investigations and biopsies should be performed for any sites suspected of malignancy, as accurate staging determines the treatment and outcome of the underlying disease.
The use of radiation diagnostics in oncology is aimed at solving the main problems:
- Early (preclinical) diagnosis of neoplasms. Recently, radiation diagnostic methods have been effectively used as screening, which makes it possible to detect neoplasms less than 1 cm in size.
- Staging, assessment of localization, prevalence, metastasis, differential diagnosis. At this stage, radiation and radionuclide methods are the most informative; on their basis, a decision is made on the tactics of treatment.
- Evaluation of the results of treatment and the dynamics of the disease. Antitumor treatment includes radiation therapy, chemotherapy, surgery, both independent methods and their combinations in various sequences. To evaluate the effectiveness of ongoing therapy, as well as an objective comparison of the results obtained in various clinics around the world, a system of criteria known as RECIST (Response Evaluation Criteria in Solid Tumors) is used. With the help of these criteria, the parameters of complete, partial responses, stabilization and progression of the disease are determined. The basis of the classification is the determination of the size of the tumor using the methods of radiation diagnostics and endoscopic methods. Thus, repeated diagnostics using radiation methods is actively used in the postoperative period and after treatment, because. gives a clear understanding of the effectiveness of therapy and allows you to plan further tactics for managing the patient.
- Dynamic observation. Modern algorithms for the treatment of oncological diseases include monitoring and conducting periodic studies using radiological methods to detect relapses.
Types of cancer and methods for its diagnosis Tumors of the ovaries
Imaging techniques, such as magnetic resonance imaging (MRI), which may provide additional information, are not essential for routine preoperative evaluation. When ultrasound findings are questionable, the use of MRI enhances the specificity of the imaging modality, thereby reducing the risk of misdiagnosis.
CT is not the method of choice for ovarian cancer, but is used when it is impossible to perform an MRI, also to assess the involvement of the lymph nodes.
Magnetic resonance imaging (MRI) is considered as an additional method of examination, superior to CT examination in assessing the extent of the tumor, but both methods are equivalent in assessing the involvement of the lymph nodes. To search for metastases, magnetic resonance imaging of the pelvis and abdominal cavity
Computed tomography can be used to detect metastatic lesions of the chest organs.
If the cervix is involved in the process, magnetic resonance imaging (MRI) with contrast enhancement is recommended
CT of the chest and abdomen is used to identify metastases
Tumors of the esophagus
To determine the prevalence of the process, search for metastases, CT of the chest and abdomen with contrast is used as an additional method.
Tumors of the stomach
Radiation diagnostic methods (MRI, CT) are used to search for metastases in the abdominal cavity and retroperitoneal space, in the pelvis, lungs and brain. For this, it is preferable to do an MRI of the abdominal cavity, small pelvis, brain and CT of the lungs.
Tumors of the pancreas
CT and MRI with contrast are considered the best diagnostic methods.
MRI will provide more accurate information on tumor detection, and CT will more accurately determine invasive growth, which is important for operative surgical volume.
All organs of the abdominal cavity and retroperitoneal space have a tendency to metastasize to the lungs, brain, and small pelvis.
Tumors of the liver
Contrast-enhanced MRI is considered the optimal method for diagnosing liver masses, and the use of hepatospecific contrast agents has an additional advantage for this pathology.
For adequate staging of the tumor, CT of the chest and CT of the abdominal organs are
Cancer of the gallbladder and bile ducts
The diagnosis should be based on radiological MRI data and pathological confirmation of the diagnosis.
Virtual colonoscopy (a non-invasive method based on radiation diagnostics) is able to accurately visualize the location of the tumor, which is especially useful in combination with the endoscopic method in planning the extent of the surgical operation.
Magnetic resonance imaging of the rectum can provide the surgeon with comprehensive information regarding the stage of the process, determine the characteristics of the blood supply, and help form an understanding of the scope of the operation and surgical access.
Computed tomography, in this case, is performed to detect metastases (abdomen, lungs, brain).
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As a screening diagnostic method, virtual colonoscopy is used (a non-invasive method based on radiation diagnostics)
CT is used to look for metastases
Tumors of the lungs and mediastinum
Chest CT is the main method of diagnosis.
Since lung cancer often metastasizes to the abdomen and brain, CT/MRI of the abdomen and MRI of the brain are reasonable.
Tumors of the kidneys
This disease is diagnosed on CT, the connections with the renal arteries, the degree of germination in the pyelocaliceal system and extraorganic spread and impact are determined.
Magnetic resonance imaging is also widely used in this area. Both CT and MRI studies are performed using contrast
Tumors of the bladder
Pelvic MRI with contrast
The presence of metastases is looked at by CT in the lungs and abdominal cavity.
Prostate and testicular cancer
Magnetic resonance imaging of the small pelvis, allows you to assess in detail the structure of the prostate gland, the prevalence of the pathological process, involvement in the process of surrounding tissues, lymph nodes
Because prostate cancer often metastasizes to the bones, then in the later stages of the disease, osteoscintigraphy is performed
Radiation diagnostics (computed, magnetic resonance imaging with contrast) allows you to identify the presence of tumor formations in various anatomical areas that are not available to the doctor during an external examination
The main diagnostic method is MRI. This type of study is necessary to clarify the localization of the tumor, determine the degree of prevalence
MR – tractography will be able to indicate the degree of involvement of the pathways of the brain (tracts)
Computed tomography is used as an additional method if bone structures are involved in the process. Also, CT is performed in the presence of absolute contraindications for MRI examination.
Tumors of the spinal cord
Magnetic resonance imaging is used to determine the location of the tumor, its level and position (intramedullary or extramedullary tumors, i.e. located in the structure of the spinal cord or outside it). In case of contraindications to MRI , CT is performed
Radiation diagnostics is not used to detect melanoma as such, but due to active metastasis, CT and MRI are performed.
Depending on the location, MRI/CT is used. In addition to local information in the area of interest, CT / MRI diagnostics of other areas can reveal the spread of the tumor to other organs, damage to the lymph nodes.
MRI of soft tissues gives an understanding of the spread of a bone tumor to them.
is used to determine the stage and assess the effectiveness of treatment Whole-body MRI .